Mastery of basic-surgical techniques is dependent on correct performance of specific motor skills, combined with appropriate rapidity of motion, automaticity of motion, and delicacy of motion. Specific basic-surgical skills include: cutting, knot-tying techniques, suturing techniques, dissection, clamping, clipping, grasping, ligating, cannulation, stapling, cauterization, and suture cutting, among others. Inanimate materials simulating biological tissues or organs or preserved animal tissues are cost-effective materials generally used as simulations of living tissues for the teaching and learning of basic surgical techniques. These skills are generally learned by observation and didactic instruction from an accomplished surgeon tutor. Learning of these basic skills can be enhanced by viewing video presentations of procedure-specific instructions.
Repetitive practice of these skills is necessary to achieve competency and subsequent mastery characterized by rapidity, automaticity, and delicacy. Coordinated motions of both hands to move and stabilize tissues with the non-dominant hand and precise cutting, clamping, or suturing by the dominant hand are characteristic of most basic surgical tasks.
Short initial periods of observation by the tutor of a trainee usually enables the acquisition of proper technique(s), and sequencing of actions. Because of time limitations, the initial tutor is generally unable to assure and oversee the acquisition of mastery. In most cases, a trainee needs to practice these basic-surgical techniques hundreds or even thousands of times to achieve rapidity, automaticity, and delicacy of the techniques.
While this repetitive practice to achieve mastery has traditionally been achieved while the trainee practices operative techniques on living patients after an initial introduction to basic technical principles, practice in a safe surgical-simulation environment is preferable for reasons of patient safety.
Presently, there exist virtual and non-virtual simulators on which to practice basic-surgical skills. Most virtual simulators rely on sophisticated haptic sensors and software integrated with large computer systems that are immobile and often extremely expensive. Teaching institutions that can afford them are usually only able to purchase a limited quantity. Therefore, students often have restricted access and limited times to practice surgical techniques using virtual simulators.
Furthermore, most virtual simulators are designed to teach advanced-surgical procedures, such as organ-specific laparoscopic surgery and robotic surgery, or endoscopic or endovascular procedures. These simulators are typically designed for trainees already competent or masterful with basic-surgical techniques and do not offer a suitable environment for practicing basic-surgical skills. Some virtual simulators do provide feedback to the trainee of excessive roughness during the task performance.
Additionally, many virtual training environments require the observation of skill performance in a two-dimensional environment on a planar video monitor screen that fails to provide a realistic three-dimensional environment required for initial learning and practice of basic surgical skills.
Non-virtual surgical-simulator tools such as tissue models and knot-tying boards permit the trainee to practice basic-surgical techniques, but without feedback whenever excessive forces are applied. Although the trainee may repetitively practice the technique on such training devices and ultimately become more proficient, the trainee may also unknowingly use and engrain excessively forceful surgical manipulations in so doing. In subsequent live practice, such overly forceful manipulations can shear, tear, or damage the living tissue of a patient.